The incidence of malignant scalp tumors which require radical excision increases with age. Reconstructing a multilayer scalp defect is a challenge for the reconstructive teams because of the soft tissue variability and paucity of available tissue. There is a wide range of options for treating scalp defects, from primary closure to free tissue transfer. In this study, nine patients who underwent reconstruction of large scalp defects after malignant tumor resection by using free tissue transfer were evaluated and reported. Eight patients died within two years after the surgery due to local recurrence (%88.9), and only one patient is still alive without any problems with a mean follow-up of 32 months. Many free tissue transfers have been reported on, with varied results. In the postoperative period, local and systemic complications can be seen, which do not correlate with age. Local tumor recurrence is another serious problem. Tumor complications and recurrences are the factors which affect the survival rates in patients. In this study we report on the scalp defect reconstruction after tumor resection with results and survival rates.